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General NPI Number Information
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NPI Number | 1780866459
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Entity Type | Organization
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Legal Business Name | INTERMOUNTAIN FOOT & ANKLE ASSOC P.C
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 9348 GRAND CORDERA PKWY STE 210
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City | COLORADO SPRINGS
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State | CO
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Zip | 80924-7002
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Country | US
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Telephone | 719-594-9920
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Fax | 719-598-6212
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Provider Business Mailing Address
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Address Line | 9348 GRAND CORDERA PKWY 210
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City | COLORADO SPRINGS
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State | CO
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Zip | 80924-4062
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Country | US
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Telephone | 719-594-9920
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Fax | 719-598-6212
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. KERRY ELIZEBETH BERG
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Credential | D.P.M.
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Telephone | 719-594-9920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 517
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License Number State | CO
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